title: Efficacy of combination of glycolic acid peeling with topical regimen in treatment of melasma.
abstract: BACKGROUND
  Various treatment modalities are available for management of melasma, ranging from topical and oral to chemical peeling, but none is promising alone. Very few studies are available regarding efficacy of combination of topical treatment with chemical peeling. Combination of chemical peeling and topical regimen can be a good treatment modality in the management of this recalcitrant disorder.
  
  
  OBJECTIVE
  To assess the efficacy of combination of topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling in the treatment of melasma in Indian patients.
  
  
  METHODS
  Forty Indian patients of moderate to severe epidermal variety melasma were divided into two groups of 20 each. One Group i.e. peel group received topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling and other group i.e. control group received topical regimen (2% hydroquinone, 1% hydrocortisone, 0.05% tretinoin).
  
  
  RESULTS
  There was an overall decrease in MASI from baseline in 24 weeks of therapy in both the groups (P value < 0.05). The group receiving the glycolic acid peel with topical regimen showed early and greater improvement than the group which was receiving topical regimen only.
  
  
  CONCLUSIONS
  This study concluded that combining topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling significantly enhances the therapeutic efficacy of glycolic acid peeling. The combination of glycolic acid peeling with the topical regimen is a highly effective, safe and promising therapeutic option in treatment of melasma.
authors.forename: Savita
authors.initials: S
authors.lastname: Chaudhary
authors.forename: Surabhi
authors.initials: S
authors.lastname: Dayal
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000975:Antioxidants / Q000009:adverse effects / Q000627:therapeutic use; D002615:Chemexfoliation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006016:Glycolates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000627:therapeutic use; D006873:Hydroquinones / Q000009:adverse effects / Q000627:therapeutic use; D017495:Hyperpigmentation / Q000139:chemically induced; D006983:Hypertrichosis / Q000139:chemically induced; D007509:Irritants; D007641:Keratolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008548:Melanosis / Q000188:drug therapy*; D016896:Treatment Outcome; D014212:Tretinoin / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D006016:Glycolates; D006873:Hydroquinones; D007509:Irritants; D007641:Keratolytic Agents; C031149:glycolic acid; D014212:Tretinoin; D006854:Hydrocortisone; C031927:hydroquinone